Command and control in hospitals during SARS-CoV-2 pandemic: The windmill model of disaster response


  • Thomas Wurmb, MD
  • Georg Ertl, MD
  • Ralf-Ingo Ernestus, MD
  • Patrick Meybohm, MD



disaster response command and control contingency care, crisis care, mass critical care


Hospitals are the focus of the fight against SARSCoV-2 pandemic. To meet this challenge hospitals need a Disaster Response Plan and a Hospital Incident Command System (HICS) as a crisis leadership tool. The complex dependency between the systems staff, supplies, and space during the SARS-CoV-2 pandemic is a major problem for hospitals. To take the appropriate countermeasures, the effects of the crisis on these systems must be detected, analyzed, and displayed. The presentation and interpretation of such complex processes often poses serious problems for the hospitals’ incident commanders.

In this article, we describe a new model that is able to display these complex interrelationships within the command process. The model was developed and deployed during the disaster response to SARS-CoV-2 pandemic in order to facilitate the entire command process and to improve hospital disaster response. The approach of the model is as simple as it is innovative. It perfectly symbolizes the basic principle of disaster medicine: keep is safe and simple. It will help hospitals to improve command and control and to optimize the disaster response during SARS-CoV-2 pandemic.

Author Biographies

Thomas Wurmb, MD

Professor, Head of the Section Emergency- and Disaster Relief Medicine, Department of Anaesthesia and Critical Care, University Hospital Wuerzburg, Wuerzburg, Germany

Georg Ertl, MD

Professor, Board of Directors, University Hospital of Wuerzburg, Wuerzburg, Germany

Ralf-Ingo Ernestus, MD

Professor, Head of the Department of Neurosurgery, University Hospital of Wuerzburg, Wuerzburg, Germany

Patrick Meybohm, MD

Professor, Head of the Department of Anaesthesia and Critical Care, University Hospital Wuerzburg, Wuerzburg, Germany


Nacoti M, Ciocca A, Giuppone A, et al.: At the epicenter of COVID-19 pandemic and humanitarian crisis in Italy: Changing perspectives on preparation and mitigation. NEJM Catalyst. 2020; 10: 1-5. doi:10.1056/CAT.200080.

Hick JL, Biddinger PD: Novel Coronavirus and old lessons—preparing the health system for the pandemic. NEJM. 2020; 382: e55 1-3. doi: 10.1056/NEJMp2005118.

Gauss T, Pasquier P, Joannes-Boyau, et al.: Preliminary pragmatic lessons from SARS-CoV-2pandemic from France. Anaesth Crit Care Pain Med. 2020; 39: 329-332. doi:10.1016/j.accpm.2020.05.005.

Hick JL, Sharon E, Hanfling D, et al.: Surge capacity principals: Care for the critically ill and injured during pandemics and disasters—CHEST Consensus Statement. Chest. 2014; 146 (Suppl): e1S-e16s.

Hick JL, Barbera JA, Kelen GD: Refining surge capacity: Conventional, contingency and crisis capacity. Disaster Med Public Health Prep. 2009; 2 (Suppl): S59-S67.

Carenzo L, Costantini E, Greco M, et al.: Hospital surge capacity in a tertiary emergency referral centre during the COVID-19 outbreak in Italy. Anaesthesia. 2020; 75 (7): 928-934.




How to Cite

Wurmb, MD, T., G. Ertl, MD, R.-I. Ernestus, MD, and P. Meybohm, MD. “Command and Control in Hospitals During SARS-CoV-2 Pandemic: The Windmill Model of Disaster Response”. Journal of Emergency Management, vol. 18, no. 7, July 2020, pp. 19-22, doi:10.5055/jem.2020.0520.